Athletes' Hunger to Win
Fuels Eating Disorders

She was transferring from Colorado State to
Indiana University, and one day she felt she had eaten too much. "The idea
popped into my head that I could get rid of this," she says.

And so she threw up.

That set her on a desperate course. At one
point, she says, she was "purging pretty much everything I ate. I was so
obsessed about calories that I didn't want to chew gum because there are 5
calories in a stick."

She struggled secretly with bulimia for 1
1/2 years, feeling "shameful and embarrassed" about what she was doing, before
she sought out a psychologist who specialized in eating disorders. "When I
finally did seek help, I felt like I had a blinking neon sign on my forehead
that said 'bulimic, bulimic, bulimic,' and that's all people would see."

Disordered eating -- reported by one-third
of female athletes in college -- is just one element in a spectrum of health
problems many confront, studies show. Despite the opportunities that have
opened up to women since Title IX of the Education Amendments of 1972 banned
sex discrimination in schools that receive federal money, universities report
that an increasing number of these competitors are suffering from depression
and anxiety disorders. They struggle to juggle practices, competitions and
academic demands. Some are so overwhelmed that, despite their athletic talent,
they drop their sports or even drop out of college. There are extreme cases of
anorexia and suicide even among elite athletes.

"It would be hard to find a female athlete
in the aesthetic sports -- gymnastics, diving, cheerleading, figure skating --
who isn't preoccupied with body image and somewhat obsessive about what she is
eating," says Soldati, 31, who is married to Purdue University diving coach
Adam Soldati. They have a 3-month-old baby.

Since her recovery, she has spoken to
hundreds of women who have troubling eating patterns, which includes dieting
constantly, abusing laxatives, taking diet pills or occasionally binge eating
and purging by means that include vomiting. Or they may have more serious
eating disorders such as anorexia nervosa, characterized by self-starvation, or
bulimia nervosa, frequent bingeing and purging.

"Athletes are driven personalities,
completely focused as people pleasers, almost obsessive-compulsive," says Jenny
Moshak, assistant athletics director for sports medicine at the University of
Tennessee, which has led the way in offering counseling as part of its sports
programs. "People who have addictive tendencies gravitate toward athletics."

Those obsessions can go far beyond the
playing fields.

Anorexia and bulimia are psychiatric
illnesses, but they often coexist with other emotional problems, such as
anxiety and depression, says B. Timothy Walsh, a professor of psychiatry at New
York Psychiatric Institute/Columbia University and author of If Your Adolescent
Has an Eating Disorder.

For some, the eating disorder is triggered
by an emotional problem, Walsh says; but for others, the disorder seems to
develop on its own without other significant psychological factors.

Sobering numbers

At least one-third of female athletes have
some type of disordered eating, according to two studies of college athletes
done by eating disorder experts, one in 1999 by Craig Johnson of the Laureate
Psychiatric Clinic and Hospital in Tulsa and another in 2002 by Katherine
Beals, now at the University of Utah in Salt Lake City.

In the 2002 study of 425 female college
athletes, 43% said they were terrified of being or becoming too heavy, and 55%
reported experiencing pressure to achieve or maintain a certain weight. Most
said the pressure was self-imposed, but many also felt pressure from coaches
and teammates.

Disordered eating is probably much more
pervasive than people realize, says registered dietitian Ann Litt, author of
Eating Well on Campus and Fuel for Young Athletes. "You can't tell by looking
at women that they are suffering with this, and many women fade in and out of
it. Sometimes it rears its ugly head when they are going through some rough
times in their lives."

Says Leslie Bonci, director of sports
nutrition at the University of Pittsburgh Medical Center: "This is a tough
topic to talk about, but it's not going away, and it's wreaking havoc on
campuses."

Psychologist Ron Thompson, who consults
with Indiana University's athletic department and the National Collegiate
Athletic Association, counseled Soldati. "It is a problem at all colleges,
although it may be a little more of a problem at Division I than Division II
and III," he says.

'Horrific' eating patterns

About 2% to 3% of female college athletes
have full-fledged, diagnosable eating disorders, about the same as the general
population, according to several studies. There have been high-profile cases
such as Christy Henrich, the former world-class gymnast who had anorexia and
died at age 22 in 1994 from multiple-organ failure. She weighed less than 50
pounds.

Bonci recently received a desperate call
from a college coach in Pennsylvania. He wanted her to come talk about the
importance of healthy eating to his team of female cross-country runners
because they were competing with each other at dinner to see who could eat the
least. "Some of the girls who were running 70 miles a week were eating only one
baby carrot at a meal," Bonci says. "That was it. It was horrific."

Another time, she worked with a female
college soccer player who would go to team practice for three hours a day and
then would go over to the fitness center and spend another three hours on the
treadmill.

"An athlete with disordered eating doesn't
see food as fuel that helps build her body but as calories and fat. In their
world, food has become a four-letter word," says registered dietitian Lisa
Dorfman, the sports nutritionist for the University of Miami. "When they start
asking if ketchup has sugar in it, I know we are in trouble."

People with disordered eating are not
comfortable with their bodies, Dorfman says. "They may be self-conscious about
how they look in their uniforms. They may be pinching their thighs. They don't
want their belly to show. They may look at other people on the team and compare
themselves."

Bonci agrees. "They look at the bodies on
the cover of Glamour and Shape magazines and think those bodies are better than
theirs."

The 'thin-build' sports

Female athletes who seem especially
vulnerable to disordered eating and excessive exercise are in either the
"thin-build sports" or activities that require a lean body weight, such as
long-distance running, gymnastics, swimming, diving, figure skating, dance,
cheerleading, wrestling and lightweight rowing, says Beals, author of
Disordered Eating Among Athletes.

Athletes may start dieting to enhance their
athletic performance, and the goal is what some experts call "performance
thinness."

A cross-country runner may want to lose
weight so she's lighter and faster, Beals says. A gymnast may want to lose
weight because she thinks the judges are looking at her size and shape and that
her scores will improve if she's leaner. This may be partially true, at least
in the short term.

Performance may improve with weight loss
initially, but eventually the caloric restriction or purging habits take a toll
on the athlete's nutritional condition and subsequently her performance, Beals
says. Often this drive for thinness begins in high school and sometimes even
younger, she says.

Soldati says it's no wonder some female
athletes have body image problems. As they're developing and becoming women,
they're out there in "nothing but a skimpy little Speedo or leotard."

Sometimes the dieting begins because a
coach mentions their weight. Girls and young women tend to remember "absolutely
everything a coach ever said to them," Soldati says.

Coach: 'Don't get fat'

When Soldati was on the gymnastics and
diving teams in high school, one of her coaches jokingly told her she was
"getting big." Another time when she asked a college coach what she could do
over the summer to improve her diving, he said, "Don't get fat."

The pressure to perform and look good is
much greater in college than high school, she says. "Your scholarship may be on
the line or you may want to get a scholarship. Or you may want to be the
starter on your team or be taken to the meets. Being a female in this culture,
it's hard to have a normal relationship with food, and on top of that almost
every athlete in the aesthetic sports has to watch what she eats. It's hard not
to cross over and become obsessive."

In fact, Soldati says, the same personality
traits that made her excel at diving became a liability when it came to her
body and eating habits.

"I was a perfectionist, people pleaser,
control freak. I was a high achiever and had a high pain threshold. There's a
fine line between dedication and obsession. I thought if one hour of cardio is
good, then five hours must be great."

A sport like diving doesn't use a lot of
calories, she says, but athletes are expected to look a certain way, so "it's
hard to really enjoy food."

Soldati isn't sure whether the eating
disorder affected her performance, but it did take a toll on her emotionally.
"I felt so horrible about myself. Here I was, a supposedly amazing athlete with
a 4.0 (grade-point average) and doing all these amazing things, and yet I
couldn't stop throwing up."

She says many girls with disordered eating
and their mothers have contacted her through her website, www.kimiko-usa.com.

"I've had girls tell me that I'm the only
person who knows that they have an eating disorder. I can point them in a
direction and tell them where to get help. I let them know they are not alone
because it is such a secretive disorder."

Contributing: Andy Gardiner

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